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For example, intermediaries that connect communities and funders supporting place-based efforts are critical partners in social change efforts. These nationally and regionally focused programs and their teams are steeped in the shared challenges and opportunities in communities that seek to drive sustainable improvements in health. The authors of this piece, each with experience as both funder and intermediary, consider four key questions about what it will take to build a shared understanding of what works, for whom, and under what conditions to inform the future of community health and well-being.
What does it take to build collaborative capacity and norms for stewarding equitable change across diverse organizations in communities?
Invest in the fundamentals. It is well documented across programs and communities that there are key enabling factors that contribute to systems change. These conditions are often characterized by enhanced knowledge, strengthened relationships, community ownership, and increased capacity among partners—as outlined in The BUILD Health Challenge’s Community Approaches to Systems Change. Together, and when working in concert, these factors signal that progress is being made in addressing entrenched local systems. Despite their importance, their intangible and slowly evolving nature often means they do not fit the criteria for investment by funders for grants that require specific, time-limited outputs. Funders working to support cross-sector and community-driven collaboratives would be wise to invest in these fundamental mechanisms for change. Doing so supports capacity building in communities and helps lay the groundwork for lasting systems change.
How can we support the centering of unheard and underheard voices in the pursuit of health equity?
Shift power. Across our organizations, we have supported centering unheard and underheard voices in the pursuit of health equity using a multifaceted approach. This includes centering community-led solutions to advance national momentum for coordinated structural changes and paying attention to who has decision-making power. The approach also challenges funders to review their internal policies and practices and reflect on how their decisions are made to ensure that historically marginalized communities benefit from actions to address racist “redlining” and inequities in health, wellbeing, and opportunity. Working with funders, we deepen multisector collaboratives centered on Belonging and Civic Muscle and offer communities opportunities to reimagine our democracy in creative and equitable ways that can lead to policy reforms, as outlined in Build Health Places Network’s Policy Scan.
Helping to support governance that embeds community voice, trust, and the ability for communities to shift levers of change is not simply a best practice in community engagement, but a way in which to transform one’s own organization and the philanthropic sector more broadly. In the future, funders must seize this opportunity to decentralize funding processes to center community power in decisions, supports, and resources.
How can we design programming that supports community needs?
Align visions. Across aligned multicity and multisector learning networks, funders and intermediary organizations are considering more holistic approaches to advancing equity. This involves developing a deeper understanding of how policies and practices create and perpetuate barriers to inequality and determining with community partners codesigned interventions that are needed to build systems that are more equitable. Public, private, and nonprofit sector partners are aligning on a resident-centered vision of place that leverages assets in the built-environment and other health-promoting conditions. The result is new narratives for change in disinvested neighborhoods with more sustained impacts. In Missoula, Montana, for example, a health equity coordinator, originally funded by the Invest Health initiative, grew a resident-centered approach in the city’s department of public health. This effort became a model of effective community partnership that is now built into the city’s budget across several other agencies. The alignment of resources where and when communities need them most is critical in addressing inequities in communities and the factors influencing community investment systems.
What are the most important practices that philanthropy can embrace to support equitable, thriving communities?
Change systems. Old-style philanthropy often undercuts aspirations for large-scale, transformational change through divisive power dynamics and short-sighted projects. Such habits create resistance to change because the mindsets and behaviors associated with them are so ingrained. ReThink Health’s 2021 Pulse Check on Shared Stewardship for Thriving Together Across America points to several interconnected practices that philanthropy can embrace to more effectively catalyze equitable systemic change. Two critically important practices are prioritizing systems change and investing in those with the most to gain. Pulse Check findings indicate that making systems change the most important organizational priority has a cascade of positive effects. Organizations that prioritize systems change as their central goal are much more likely to invest in those with the most to gain—a strategy that is critical for addressing our nation’s history of systematically favoring certain people and places while harming or neglecting others.
The future of large-scale, place-based social change efforts that support community health relies on developing connections and capacity across engaged networks to more effectively share learnings and surface implications so that we can more effectively and efficiently scale norms and practices that work. By bridging the experiences of both communities and funders, intermediaries can be helpful conduits in building networks for shared learning—but only if philanthropic leaders support the strategic investment in fundamentals, shift in power, alignment of resources, and change in systems. Will you seize this opportunity for change, and in so doing help reshape the future of community health?
Jane Erickson, Director of Learning and Impact, The Rippel Foundation/ ReThink Health
Jennifer Fassbender, Program Director, Invest Health, Reinvestment Fund
Colleen Flynn, Senior Director of National Programs, Build Healthy Places Network
Emily Yu, Executive Director, The BUILD Health Challenge; Managing Director of Partnerships, de Beaumont Foundation
This article was originally published as part of Grantmakers in Health’s ongoing Views from the Field series.